# LIFESTREAM

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Harbor
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023495645
- **Authorized official:** JOHN SHEEHAN (PRESIDENT)
- **Authorized official phone:** (419) 475-4449

## Contact information

- **Practice address:** 6629 W CENTRAL AVE, TOLEDO, OH 43617-1098
- **Practice address phone:** (419) 475-4449
- **Mailing address:** P.O. BOX 8970, TOLEDO, OH 43623
- **Mailing address phone:** (419) 475-4449

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 05/04/2015
- **Last updated:** 05/04/2015